Pandemics & Asteroids

How we cope with the risk that is unlikely but if it happens, the consequences are severe

Jul 24, 2022

person jumping on big rock under gray and white sky during daytime — Photo by Sammie Chaffin on Unsplash

What do pandemics and asteroids have in common? Both are low probability, high consequence events, a uniquely troublesome category.

Risks and their consequences come in four different types.

This animated drawing illustrates the categories in which all risks and their consequences fit. The box in the upper left quadrant is the low risk probability in the high consequence end of the continuum. That’s where these events fall.

These events are so troublesome because we have little information about them, they are not likely to happen but if they do, they are devastating. Preparing for them, may signal to others you are overly cautious; and failure to prepare for them leave others thinking you were negligent.

Pandemics

The Governor of the State of New York learned from a panel report in 2006,1 the state should replace and buy additional ventilators because they would be needed in any future respiratory viral pandemic (like the 1918 Flu). Gov. Cuomo made the decision not to buy them because they were about $50,000 each, and the needs of New York for immediate emergencies (several hurricanes, for example) and other priorities outweighed the gravity of this future risk. When COVID-19 struck and there was a shortage of ventilators, Gov. Cuomo looked negligent in not purchasing the ventilators known to be useful in a pandemic. But he probably acted reasonably given competing priorities in 2006 —-so we are faced with the dilemma of the low risk, high consequence category, like pandemics.

Psychologically and often practically, immediate threats are more important and urgent, so these low probability events get pushed to the background, but not completely forgotten.

white iphone 5 c on black surface — Photo by Laura Rivera on Unsplash

How likely is it that you will break your smartphone? Is it a high risk or a low risk for your lifestyle? Would breaking it be a low consequence or high consequence for you? So you consider all of those measures and then decide the complex question: Do you pay for insurance or do you think the event is too remote or the consequences too low to warrant paying $200 or more for an insurance plan? That is the same process of analysis we make for all risks, even when the stakes are higher, like life or death.

Not everyone sees these risks the same way, just as not everyone will buy smartphone insurance.

Asteroids

There is a risk an asteroid will strike the earth, blowing apart the blue marble we call home.2 The risk is low but it is not zero; and the consequences are apocalyptic. For example, at one time there was a 2.7% risk of a certain asteroid striking Earth on April 13, 2029.3 Yet it was not until 2021 that the United States through NASA actually developed a system ready for testing that would be a defense against such an asteroid strike.4 A surveillance system was the first step. Beginning in 2014, the U.S. led the formation of a coalition of surveillance telescopes through the member countries of the United Nations as a global warning network to give us the needed time to defend against such an asteroid. This is how it works:

The International Asteroid Warning Network (IAWN) and the Space Mission Planning Advisory Group (SMPAG) are two entities established in 2014 as a result of United Nations-endorsed recommendations, and represent important mechanisms at the global level for strengthening coordination in the area of planetary defence.
The United Nations Office for Outer Space Affairs (UNOOSA) works with IAWN, which maintains an internationally recognized clearing house for the receipt, acknowledgement and processing of all NEO observations collected from observatories worldwide, by facilitating the dissemination of information related to near-Earth objects to Member States.5

So the United Nations community put resources into this low risk but highly consequential hazard. Using a distributive justice model, proportionately spreading the cost to everyone on earth through an organization like the United Nations, is the lowest impact way to fund a global threat. The high consequences weighed heavily against this relatively small per capita cost, when compared to the cost if it was shouldered by just one country or region, for example.

The 1918 Flu

The 1918 Flu has been called the once in a century pandemic. It killed 50 million people worldwide; and 675,000 in the United States.6 The United States had only passed the first statute in 1906 that would guarantee vaccine purity and safety and establish an agency to monitor it.7 Although a vaccine was produced for the 1918 flu near the end of the pandemic, it was not subject to the current risk assessment processes, and was largely a vial of stuff removed from patients infected with the 1918 influenza, and turned out (not surprisingly) to not be effective and we have no data on its safety.8 (COVID-19 has caused more than six million deaths in the world and over one million deaths in the United States, so far.9)

COVID-19 came in 2019, pretty close to that century mark from the 1918 Flu we were told to expect. We had dress rehearsals during the anthrax attacks for a public health emergency, but that wasn’t a transmissible viral infection, so quarantines, isolation and shutdowns were not important. In 2013 we had SARS, the same family of viruses we would come to know better in 2019 as COVID-19, but it did not reach the U.S., and we watched our neighbor, Canada cope with quarantine and over flowing hospitals. No vaccine was available. By 2014, a new field of law was emerging that had developed around these experiences. We had at least fifty movies depicting public health emergencies from pandemics to biological attacks (I analyzed all of them),10 but we did not take them too seriously.

red and white UNKs restaurant — Photo by Edwin Hooper on Unsplash

COVID-19

In January 2020, the United States followed the United Nations in declaring COVID-19 a public health emergency (using their respective legal processes). In March 2020, the U.S. took drastic measures to stop the wave of respiratory illness by shutting down gathering places. This disease had so many unknowns about infectiousness, transmissibility, duration, severity, vulnerabilities that it would seek, and more, but time is a critical factor in pandemics, and early measures to stop transmission is geometrically advantageous. That is, infections spread exponentially, so early intervention means a fraction of the cases and deaths .

Presumably, the federal government made a risk assessment of how many lives might be saved by a shutdown, but they likely failed to even recognize the risks of shutdowns on mental health and drug and alcohol addiction and the economy. “Slow the spread in 30 days”,11 became months and months turned into another year, and the decision would have been well served with some transparency on the risk assessment if one was done.

Yet, we have the unintended consequences of increase in alcohol and drug addiction, increased mental health illness12 and a wounded economy.13

Countermeasures for public health, like wearing masks in public places indoors proved to be highly controversial, but tended to be a debate about individual freedom balanced against protecting the public health when the risk of getting an infection was reduced only about 10% by wearing a mask (one study found this result). Individuals made their own risk assessments. Even discounting the value of public health, an individual may value even a 10% reduction in risk (like an 80 year old, for example); whereas others (a young adult, for example) may find that a 10% reduction in risk does not weigh heavily enough against the personal costs of wearing a mask. When the decision was made by government as a mandate, this was seen as an affront to person freedom by those in the second category; but as a welcome government intervention in a governmental responsibility to public health, to the first group.

Now, the vaccine risk vs. benefit. The FDA is responsible for risk assessments of vaccines. The COVID-19 vaccine program, Operation Warp Speed,14 challenged the traditional framework that normally would require years of risk assessment before approval, by using the EUA (experimental use authorization) status to make it available to the public in the time sensitive pandemic. It may be years before we assess whether the benefits outweighed the risks, but the urgency of the pandemic made our collective risk tolerance higher to avoid the unknowns of COVID-19 and “long COVID”. But not everyone weighed the risks and benefits the same for themselves. The conflict came when the federal government had to make a public health determination that the benefit of vaccines outweighed the risk to the public. The concept of public health and distributive justice did not sit well with everyone who did not believe a small personal sacrifice was outweighed by the greater good to society. Distributive justice means that everyone in a society carries a small risk to avert greater severe consequences to society. This is the principle for childhood vaccinations which carry an individual risk but have changed the survivability of infants and children of our society as a whole. Sadly, one in a million is likely to die from a childhood vaccine, in exchange for saving hundreds of thousands. No one wants to be the “one” but if the burden is distributed to everyone, and there are no “free riders” who don’t take the risk but benefit by the herd immunity around them, then you have a benefit that outweighs the risk — to society.

This means the FDA risk assessment process must be highly transparent and even more closely scrutinized when the population now includes all demographic groups (infant to the elderly), not just children, for a pandemic. This opens a huge set of possibilities of potential side effects in a magnitude never experienced in the history of the FDA.

Climate Change Risk and Consequences

This phenomena has become politically polarized, but why?

One of the reasons is the way we see the risk. Let’s accept for a moment that it is a high risk and high consequence event, so that would mean we should take action to prevent and adapt to climate change. However, we need to introduce a third dimension to our two-dimensional graph of risk categories to include the factor of time. Since climate change occurs over hundreds of years, this factor will cause the risk to be perceived differently by individuals. Some may see other risks as priorities, dwarfing the risk perception of a risk with consequences that is hundreds of years in the future. Whereas, the asteroid strike could happen at any time, and the global pandemic has been predictably every one hundred years, the time lines were more certainties and immediate. Climate change risk perception will continue to be determinative in our response, in particular, how we treat the time factor.

Final thoughts on preparing for the low risk, high consequencce events

In risk perception studies, the way we perceive risk has a lot to do with how we react to it, and one of the biggest factors is whether we have any control over it or whether it is an “act of God”. With technology we increasingly believe we have some control over whatever risk appears — pandemics, asteroids, etc. — and with that comes the anxiety of how much of our resources should be invested in the risk? Insurance is not always the simple solution. Litigation over whether COVID-19 was an “act of God” is underway in service contracts to insurance contracts as we emerge on the other side of the pandemic.15 The answer determines whether the insurance policy must pay or avoid liability with the “act of God” exception.

As a society we make collective decisions on what low risk, high consequence events we will prepare for, and as individuals we make these decisions almost daily. As a society we have much more difficulty when a third factor, time beyond our lifetimes, is part of the risk assessment. Changing the language of the conversation to one of risk perception, while acknowledging these differences and priorities, could help.

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My PhD dissertation was on risk and risk perception, and much of my empirical research since then has incorporated aspects of risk perception. It permeates our lives. Individuals make risk assessments when deciding what their children might do, or whether to drive through a caution light or stop. Society chooses to regulate activities, products and pesticides based on risk and benefit weighing and daily we make dozens of decisions based on our perception of the risks. When you wake up in the morning you face a bevy of risks. You can crawl under the bed but you will still face risks - there is some risk that the bed might fall on you. Admittedly, my view of the world through a risk assessment lens in my research probably has a lot to do with the name of my news platform you are reading, “Unintended Consequences”.

unintended consequences